Individual
MRS. TERESA ANN HERDEGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
2235 TACKETTS MILL DR, SUITE C, WOODBRIDGE, VA 22192-3036
(703) 491-1044
(703) 491-2044
Mailing address
2235 TACKETTS MILL DR, SUITE C, WOODBRIDGE, VA 22192-3036
(703) 491-1044
(703) 491-2044
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119006188
VA
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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